Single-Access Laparoscopic Rectal Resection Versus the Multiport Technique: A Retrospective Study With Cost Analysis. (February 2015)

• Record Type: Journal Article
• Authors: Bracale, Umberto; Melillo, Paolo; Lazzara, Fabrizio; Andreuccetti, Jacopo; Stabilini, Cesare; Corcione, Francesco; Pignata, Giusto
• Is Part Of: Surgical innovation. Volume 22:Number 1(2015:Feb.)
• Page Start: 46
• Page End: 53
• Publication Date: 2015-02
• Subjects: Single-incision laparoscopy -- rectal resection -- laparoscopic surgery -- minimally invasive surgery; Surgery, Operative -- Periodicals; Endoscopic surgery -- Periodicals; Laparoscopic surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Diffusion of Innovation -- Periodicals; Chirurgie opératoire -- Périodiques; Chirurgie endoscopique -- Périodiques; Chirurgie laparoscopique -- Périodiques; 617.91
• DOI: 10.1177/1553350614529668
• Languages: English
• ISSNs: 1553-3506

Abstract

Background . Single-access laparoscopic surgery is not used routinely for the treatment of colorectal disease. The aim of this retrospective cohort study is to compare the results of single-access laparoscopic rectal resection (SALR) versus multiaccess laparoscopic rectal resection with a mean follow-up of 24 months. Methods . This retrospective cohort study enrolled 42 patients. Between January 2010 and June 2012, 21 SALRs were performed. These patients were compared with a group of 21 other patients who had undergone multiport laparoscopic rectal resection. This control group had the same exclusion criteria and patient demographics. Short-term outcomes were reassessed with a mean follow-up of 2 years. Statistical analysis included the Student t test and Fisher's exact test. Finally, we performed a differential cost analysis between the 2 procedures. Results . Exclusion criteria, patient demographics, and indication for surgery were similar in both groups. The conversion rate was 0% in both groups. There were no intraoperative complications or deaths. Bowel recovery was similar in both groups. No interventions, readmissions, or deaths were recorded at 30 days' follow-up. At a mean follow-up of 24 months, all the patients with a preoperative diagnosis of cancer are still alive and disease free. Considering the selected 3 items, the mean cost per patient for single-access laparoscopic surgery and multiple-access laparoscopic surgery were estimated as 7213 and 7495 Euros, respectively. Conclusion . We think that SALR could be performed in selected patients by surgeons with high multiport laparoscopic skills. It is compulsory by law to evaluate outcomes and cost-effectiveness by using randomized controlled trials.